Hospitals' handicap

As a retired president of Newark Beth Israel Medical Center, I am dismayed at the imminent demise of two valued Newark medical facilities. Columbus and St. James hospitals are slated for closure after multimillion-dollar losses. This will total 20 New Jersey hospitals that will have disappeared in recent years.
While some point to management issues and an increase in uninsured patients as culprits, there is at least one more major factor. I saw its growth in the early '90s. Physician groups had begun siphoning off specialty services offering many surgical procedures that were profit centers for hospitals. Hospitals faced an epidemic they couldn't control.
New Jersey hospitals must accept all patients. Uncompensated care has grown exponentially, leaving the state and hospitals with large deficits. Revenues from hospital-based outpatient specialty services had substantially defrayed these losses. Smaller hospitals cannot survive this revenue loss.
Hospitals must justify and compete for esoteric services and new technology through a mandatory certificate-of-need process. Physicians and private companies aren't bound by these controls. Unless these laws are applied across the board, community hospitals will continue to close.